title: Return to sports after surgery to correct adolescent idiopathic scoliosis: a survey of the Spinal Deformity Study Group.
abstract: BACKGROUND
  There are no guidelines for when surgeons should allow patients to return to sports and athletic activities after spinal fusion for adolescent idiopathic scoliosis (AIS). Current recommendations are based on anecdotal reports and a survey performed more than a decade ago in the era of first/second-generation posterior implants.
  
  
  OBJECTIVE
  To identify current recommendations for return to sports and athletic activities after surgery for AIS.
  
  
  METHODS
  Questionnaire-based survey.
  
  
  METHODS
  Adolescent idiopathic scoliosis after corrective surgery.
  
  
  METHODS
  Type and time to return to sports.
  
  
  METHODS
  A survey was administered to members of the Spinal Deformity Study Group. The survey consisted of surgeon demographic information, six clinical case scenarios, three different construct types (hooks, pedicle screws, hybrid), and questions regarding the influence of lowest instrumented vertebra (LIV) and postoperative physical therapy.
  
  
  RESULTS
  Twenty-three surgeons completed the survey, and respondents were all experienced expert deformity surgeons. Pedicle screw instrumentation allows earlier return to noncontact and contact sports, with most patients allowed to return to running by 3 months, both noncontact and contact sports by 6 months, and collision sports by 12 months postoperatively. For all construct types, approximately 20% never allow return to collision sports, whereas all surgeons allow eventual return to contact and noncontact sports regardless of construct type. In addition to construct type, we found progressively distal LIV resulted in more surgeons never allowing return to collision sports, with 12% for selective thoracic fusion to T12/L1 versus 33% for posterior spinal fusion to L4. Most respondents also did not recommend formal postoperative physical therapy (78%). Of all surgeons surveyed, there was only one reported instrumentation failure/pullout without neurologic deficit after a patient went snowboarding 2 weeks postoperatively.
  
  
  CONCLUSIONS
  Modern posterior instrumentation allows surgeons to recommend earlier return to sports after fusion for AIS, with the majority allowing running by 3 months, noncontact and contact sports by 6 months, and collision sports by 12 months.
authors.affiliation: Department of Orthopaedic Surgery and Rehabilitation, Walter Reed National Military Medical Center, 8901 Wisconsin Ave., Bethesda, MD 20889, USA; Division of Orthopaedics, Department of Surgery, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA. Electronic address: armyspine@yahoo.com.
authors.forename: Ronald A
authors.initials: RA
authors.lastname: Lehman
authors.affiliation: Department of Orthopaedic Surgery and Rehabilitation, Walter Reed National Military Medical Center, 8901 Wisconsin Ave., Bethesda, MD 20889, USA.
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Kang
authors.affiliation: Department of Orthopaedic Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8233, St. Louis, MO 63110, USA.
authors.forename: Lawrence G
authors.initials: LG
authors.lastname: Lenke
authors.affiliation: Department of Orthopaedic Surgery, Texas Scottish Rite Hospital for Children, 2222 Welborn Street, Dallas, TX 75219, USA.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Sucato
authors.affiliation: Department of Orthopaedic Surgery and Rehabilitation, Walter Reed National Military Medical Center, 8901 Wisconsin Ave., Bethesda, MD 20889, USA.
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Bevevino
mesh_terms: D000293:Adolescent; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012600:Scoliosis / Q000534:rehabilitation / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects / Q000534:rehabilitation*; D013177:Sports; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Adolescent idiopathic scoliosis; Return to sports; Spinal deformity surgery; Sports participation